For a group of teenagers, Lauren, Fazana, Flora and Mackenzie are remarkably knowledgeable about fertility. Sitting in the library at St Marylebone school in central London, they’re explaining what they’ve learned. These year 10 girls know how common infertility is, how female fertility declines with age and they understand that IVF doesn’t always work. The discussion ranges from egg donation and surrogacy through to the dilemmas they know they may face later in life trying to balance careers with the desire for a family; “There’s never a time that’s exactly the right time to have a baby,” they explain.

It’s something every girl at St Marylebone will cover in their religious studies lessons, where the curriculum covers religious attitudes to family, relationships and family planning, as well as the ethics of fertility treatments. But in some other schools this highly topical issue barely gets a mention. IVF may be covered as a technological advance in science, but infertility isn’t part of the sex education curriculum, where the focus is on preventing pregnancy and sexually transmitted infections. This may seem sensible when dealing with young people, but the reality is that pupils are far more likely to have a fertility problem in the future than they are to get pregnant while they’re still at school. The teenage pregnancy rates for England and Wales are the lowest they’ve been since the 1960s, but infertility rates are rising; one in six of the population will experience problems getting pregnant – that’s about five pupils in each class of 30.

Prof Michael Reiss, of the Institute of Education, who founded the journal Sex Education, says infertility isn’t covered because it hasn’t been seen as a priority. “It’s not wilful, but these things are determined by the previous generation’s issues. The situation was always portrayed as if everyone wanted to be a parent at 15 or 16, and as if the major job was to stop them doing so or being infected with an STI and that has dominated the discourse. It’s just that people don’t think about infertility.”

Jane Knight is a fertility nurse specialist who has been invited in to schools to talk to teenagers about fertility awareness, but her lessons are usually one-off sessions, squeezed in wherever a school feels they may fit. “There is no cohesion when it comes to fertility education in schools, nothing joined up,” she says. “I try to give teenagers information in a way that is relevant to them and I talk about protecting fertility. They have learned about IVF, but it’s so far removed from where they are at that it’s almost irrelevant.”

Of course, it isn’t easy to get teenagers to think years ahead, but there is clearly room for improvement when it comes to fertility awareness. When the sexual health charity FPA investigated young people’s knowledge about sex and reproduction, they found widespread confusion, as Rebecca Findlay, of FPA, explains. “Our research revealed many very basic misunderstandings about fertility. It showed that sex and relationships education is letting young people down, and that they are aware of that – just 4% rated the sex education they’d received as excellent.”

When it comes to fertility, it isn’t just young people who are confused. Despite what can seem like a constant stream of media messages about the impact of age and lifestyle on fertility, many people still don’t really appreciate that a woman’s fertility begins to decline rapidly at 35, or that obesity, eating disorders, smoking and drugs can all affect your chances of having a family. A recent study of undergraduates in the US found that most thought female fertility declined far later than it does and that they overestimated both the chances of getting pregnant after unprotected intercourse and the likelihood of success after fertility treatment. Attempting to redress this balance is something they are taking seriously in Scotland, where plans for a Fertility Education Project are under way, with funding for two part-time workers who will help to raise awareness of infertility among students and the wider community.

For those elsewhere in the UK, knowledge about infertility looks set to remain patchy. This has led fertility specialists to call for a change to the school curriculum, as Dr Allan Pacey, senior lecturer at Sheffield University and chair of the British Fertility Society, explains. “I don’t think we do sex education well enough in schools. We don’t give people the skills they need for fertility planning. I understand that from the point of view of teenage pregnancy it is essential to focus on contraception, but that is only one side of the coin. We could do so much more for young people – most are very naive when it comes to fertility. I would package it as fertility advice rather than infertility advice, but I do think it should be part of the sex education curriculum.”

It is in fertility clinics that our failure to get the message across is really felt by those who discover that their chances of getting pregnant are not as good as they had hoped. Clare Lewis-Jones, chief executive of the charity Infertility Network UK, sees at first hand the distress this can cause. “It is vital that we get information out there so that people make informed choices at the right time in their lives and avoid the heartache infertility can cause,” she says. “Of course, not all fertility problems are caused by lifestyle choices, but we do hear from those who would have done things differently if they had known more about how lifestyle choices would affect their chances of having a family.”

There are sensitivities surrounding the idea of teaching young people that getting pregnant isn’t always easy, perhaps due to anxieties that this could water down messages about teenage pregnancy prevention, but Sarah Swan, assistant head at St Marylebone, believes it is important to give their girls the full picture. “You’ve got to give young people the facts and educate them about the realities to help them make the right decisions. You can’t decide not to give them information because you are worried that it might lead to problems.”

Far from leading to problems, Reiss suggests that giving young people all the facts could bring benefits. “Teaching about infertility in schools wouldn’t increase teenage pregnancy rates. In fact, if it was part of a coherent, high-quality sex education programme, I would expect it to lower teenage pregnancy rates.”

With ever-increasing numbers seeking medical help to conceive, and warnings that infertility rates may rise yet higher, it seems that ensuring our teenagers are properly educated about fertility might not only help to prevent future problems, but could be beneficial in the present.

Eating avocados and foods high in monounsaturated fat can triple the success of your in vitro fertilisation (IVF) treatment. But is there anything else you can do to improve your IVF success?

A new study carried out by researchers at the Harvard School of Public Health found that eating monounsaturated fat – found in olive oil, sunflower oil, nuts and seeds – could help women trying to have a baby through in vitro fertilisation (IVF). It’s believed that these “good fats” – which are already known to protect the heart – could improve fertility by lowering inflammation in the body.

In contrast the research revealed that women who ate a diet rich in saturated fat (found in red meat and butter) produced fewer healthy eggs for use in fertility treatment. Another study showed that drinking five or more cups of coffee a day halved the chance of successful IVF treatment.

Dr Ulrik Schixler Kesmodel, from the Fertility Clinic of Aarhus University Hospital in Denmark, said: “Although we were not surprised that coffee consumption appears to affect pregnancy rates in IVF, we were surprised at the magnitude of the effect.”

But along with eating a healthy diet, what else can you do to improve your chances of conceiving under IVF? Tertia Albertyn, Owner of Nurture Egg Donor and Surrogacy Program, provided the following tips:

5 tips to improve your IVF success

1. Make sure you are at the best fertility clinic for your needs. “Best” can be defined in many ways – highest success rate, best bedside manner, most value for money. You are making an enormous financial and emotional investment, so make sure your expectations are met.

2. Make sure your expectiations are realistic. If you are 45 years old and you are using your own eggs, your chance of success is probably only around 5%. Your chance of having a baby through donor eggs is around 65%. If you only have the resources for one attempt, make sure you maximise your odds.

3. Prepare yourself emotionally. Know that IVF takes a huge toll emotionally; be prepared for the roller-coaster ride. You will feel so many emotions at once: hope / fear / excitement / terror. Have someone to support you through the process. Go online and join a fertility support forum, it can be done anonymously if you are keeping it private and confidential. Don’t be ashamed to seek professional support if you need it.

4. Prepare yourself physically. Stop smoking, cut down on the wine. Eat well. Drink water. Stick to one cup of coffee a day. Don’t eat fatty foods. Step away from the cheese cake, burgers and fries. But don’t punish yourself, have that glass of wine on a Friday night. Enjoy that rare cappuccino. Infertility is hard enough without denying yourself the occasional indulgence.

5. Go alternative: Just because you are doing something high tech / traditional medicine, doesn’t mean you can’t use alternative approaches to maximise your chances. Investigate things like fertility acupuncture, fertility reflexology or fertility astrology. Make sure you go to someone reputable who has experience in this area. Always check with your doctor first.

Lastly, always have a Plan B, said Albertyn. “Having a Plan B (another IVF / another option like donor eggs) kept me sane. If this one doesn’t work, then we will do XYZ or try ABC. Knowing that this wasn’t the end of the road made the failures more tolerable for me,” she said.

The pioneering surgeon behind the world’s first ovary transplant says women could use the same technique to delay childbearing and the menopause.

Dr Sherman Silber predicted that ovarian transplants for social reasons were a realistic option for preserving fertility.
The US microsurgeon transplanted a whole ovary from one identical twin to another in 2007, who had been made infertile when her ovaries failed at the age of 15. The 38-year-old woman gave birth following year.

The drugs used may destroy the ovaries, so slices are taken in advance and stored in the deep freeze. They can be re-implanted when the woman is ready to start a family and so far 22 women have given birth after having their own ovarian tissue restored.

The latest success was achieved in Italy seven years after a 21-year-old woman had ovarian tissue frozen prior to cancer treatment.
Details were released at the annual meeting of the European Society of Human Reproduction and Embryology in Istanbul, Turkey.

Dr Silber, who practises at the Infertility Center of St Louis, Missouri, presented his own data on three women who had frozen and thawed ovary grafts and nine women who had fresh ovary grafts, usually donated by relatives.

One woman had ovarian tissue implanted to treat premature menopause caused by cancer drugs, while another had a graft to treat a naturally premature menopause. Eight babies have been born in total to the women, with one graft lasting seven years so far.

Dr Silber said: ‘Transplanted cryopreserved or fresh ovarian tissue can robustly restore menstrual cycles and fertility and may even in the future be used to postpone the normal time of menopause or to alleviate its symptoms.’
It was a remedy for severe bone loss caused by premature menopause because the new ovary would supply the body’s missing hormones, he said.

At present women going through a premature menopause in their 20s or 30s are offered Hormone Replacement Therapy to alleviate the symptoms. Dr Silber has previously claimed ovary transplants could be a solution to growing fertility problems caused by delayed childbearing among career women. He said: ‘It is the modern way, It is not just England and the US – in every society women are putting off childbearing.’

In 2008 he predicted that women who had an ovary frozen in their 20s could look forward to the best of all worlds. They would have their own young eggs in storage that were superior to donor eggs, he said.

‘It’s very realistic. Women can always have egg donation but this is so much nicer and more convenient if it’s safe. ‘A young ovary can be transplanted back at any time and it will extend fertility and delay the menopause. You could even wait until you were 47.

‘I don’t see any problem with it at all, I don’t see a dilemma’ he added. However, British experts said ovarian transplant techniques were originally developed to help women facing infertility through cancer treatment and this was likely to remain the case for the foreseeable future.

Professor Nick Macklon, medical director of the Complete Fertility Centre, Southampton, and chair in obstetrics and gynaecology at Southampton University, said ovarian tissue freezing for cancer patients was beginning to become established in the UK. He is starting the third centre and is ‘optimistic’ about getting NHS funding for the service.
He said ‘The technique is novel but not experimental.

‘It’s very important for girls who have no other option and who face losing their fertility because of cancer treatment at the age of eight or nine.’ But, he added, using the technique for social reasons raised ethical issues that would need to be debated by society as well as doctors.